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Serum voriconazole

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https://www.readbyqxmd.com/read/28805964/therapeutic-drug-monitoring-of-voriconazole-for-treatment-and-prophylaxis-of-invasive-fungal-infection-in-children
#1
Sarah Allegra, Giovanna Fatiguso, Silvia De Francia, Fabio Favata, Elisa Pirro, Chiara Carcieri, Amedeo De Nicolò, Jessica Cusato, Giovanni Di Perri, Antonio D'Avolio
Voriconazole therapeutic drug monitoring is not consistently recommended due to its high interpatients and intrapatients variability. Here, we aimed to describe our experience with voriconazole for treatment and prophylaxis of invasive fungal infections, in paediatric patients. A fully validated HPLC-MS method was used to quantify voriconazole concentration in plasma, at the end of dosing interval. A high interindividual variability was shown. We enrolled 237 children, 83 receiving intravenous and 154 oral voriconazole...
August 14, 2017: British Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28795522/assessment-of-carvacrol-for-control-of-avian-aspergillosis-in-intratracheally-challenged-chickens-in-comparison-to-voriconazole-with-a-reference-on-economic-impact
#2
Y H Tartor, F A M Hassan
AIM: This study was designed to investigate the efficacy of essential oils (EOs) as an alternative prophylaxis and treatment for avian aspergillosis. METHODS AND RESULTS: The in vitro susceptibility of A. fumigatus strains to antifungal drugs and carvacrol, thymol, eugenol, thymoquinone and cinnamon was determined using the macro-diffusion and microdilution methods. Carvacrol has antifungal activity in comparison to voriconazole (VCZ) (MIC 0.5, 0.25μg/ml, respectively)...
August 9, 2017: Journal of Applied Microbiology
https://www.readbyqxmd.com/read/28795412/severe-neurological-disorders-and-refractory-aspergillosis-in-an-adolescent-treated-by-vincristine-and-voriconazole
#3
Y Bennis, S Bodeau, A Lutun, A Gourmel, C Solas, S Quaranta, N Guillaume, T Chouaki, A-S Lemaire-Hurtel, K Masmoudi
WHAT IS KNOWN AND OBJECTIVE: Voriconazole and vincristine are major therapeutics in paediatric haematology. However, the risk-benefit ratio of the treatment of invasive aspergillosis with voriconazole in patients receiving vincristine-based chemotherapy remains unclear. CASE DESCRIPTION: We report severe peripheral and central neurological disorders in a 14-year-old girl with T-cell acute lymphoblastic leukaemia and pulmonary aspergillosis. The case describes a strong exacerbation by voriconazole of the vincristine-induced neuropathic pains...
August 10, 2017: Journal of Clinical Pharmacy and Therapeutics
https://www.readbyqxmd.com/read/28742650/reliable-and-easy-to-use-liquid-chromatography-tandem-mass-spectrometry-method-for-simultaneous-analysis-of-fluconazole-isavuconazole-itraconazole-hydroxy-itraconazole-posaconazole-and-voriconazole-in-human-plasma-and-serum
#4
Carsten Müller, David Gehlen, Cornelia Blaich, Domenik Prozeller, Blasius Liss, Thomas Streichert, Martin H J Wiesen
BACKGROUND: A fast and easy-to-use liquid chromatography-tandem mass spectrometry (LC-MS/MS) method for the determination and quantification of six triazoles (fluconazole (FLZ), isavuconazole (ISZ), itraconazole (ITZ), hydroxy-itraconazole (OH-ITZ), posaconazole (PSZ), voriconazole (VRZ)) in human plasma and serum was developed and validated for therapeutic drug monitoring (TDM). METHODS: Sample preparation was based on protein precipitation with acetonitrile and subsequent centrifugation...
July 24, 2017: Therapeutic Drug Monitoring
https://www.readbyqxmd.com/read/28636889/complications-of-hematopoietic-stem-transplantation-fungal-infections
#5
REVIEW
Ali S Omrani, Reem S Almaghrabi
Patients undergoing allogeneic hematopoietic stem cell transplantation (HSCT) are at increased risk of invasive fungal infections, especially during the early neutropenic phase and severe graft-versus-host disease. Mold-active prophylaxis should be limited to the highest risk groups. Empiric antifungal therapy for HSCT with persistent febrile neutropenia is associated with unacceptable response rates, unnecessary antifungal therapy, increased risk of toxicity, and inflated costs. Empiric therapy should not be a substitute for detailed work up to identify the cause of fever in such patients...
June 13, 2017: Hematology/oncology and Stem Cell Therapy
https://www.readbyqxmd.com/read/28630185/in-vivo-biomarker-analysis-of-intranasally-dosed-pc945-a-novel-antifungal-triazole-on-aspergillus-fumigatus-infection-in-immunocompromised-mice
#6
Genki Kimura, Takahiro Nakaoki, Thomas Colley, Garth Rapeport, Pete Strong, Kazuhiro Ito, Yasuo Kizawa
PC945 is a novel triazole optimised for lung delivery and the objective of this study is to determine the effects of intranasally dosed PC945 on Aspergillus fumigatus infection and associated biomarkers in immunocompromised mice. PC945, posaconazole or voriconazole was treated intranasally once daily on days 0 to 3 (early intervention) or days 1 to 3 (late intervention) post-infection in temporarily neutropenic A/J mice infected intranasally with A. fumigatus, and bronchoalveolar lavage fluid (BALF) and serum were collected on day 3...
June 19, 2017: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/28624887/voriconazole-induced-qt-prolongation-among-hemato-oncologic-patients-clinical-characteristics-and-risk-factors
#7
I Gueta, R Loebstein, N Markovits, Y Kamari, H Halkin, G Livni, H Yarden-Bilavsky
PURPOSE: The purpose of this study is to determine the rate of QTcP and associated risk factors in patients treated with voriconazole. METHODS: We conducted a retrospective chart review of all patients treated with voriconazole in a large tertiary center between 2009 and 2015, using paired comparison of QTc intervals on and off voriconazole treatment, adjusted for comorbidities, electrolyte abnormalities, and concurrent medications. RESULTS: Fifty-four patients were included, of whom 53 were diagnosed with oncologic/hemato-oncologic disease...
September 2017: European Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28568285/claviform-aspergillus-related-vegetation-in-the-left-ventricle-of-a-patient-with-systemic-lupus-erythematosus
#8
Tetsushi Yamamoto, Shimpei Kasagi, Chiyo Kurimoto, Takamitsu Imanishi, Nobuhide Hayashi, Akio Morinobu, Jun Saegusa
A 38-year-old woman was diagnosed with systemic lupus erythematosus and received immunosuppressive therapy. After 6 months of treatment, workup for low-grade fever yielded elevated enzyme-linked immunosorbent assay titers for Aspergillus antigen in serum and ascites, leading to the diagnosis of disseminated aspergillosis. Transthoracic echocardiography revealed a claviform vegetation attached to the left ventricular anterior septum. Two days after the start of antifungal Amphotericin-B therapy, the patient suffered from several neurologic disorders...
June 1, 2017: Journal of Clinical Ultrasound: JCU
https://www.readbyqxmd.com/read/28497121/implementation-of-isavuconazole-in-a-fluorescence-based-high-performance-liquid-chromatography-kit-allowing-simultaneous-detection-of-all-four-currently-licensed-mold-active-triazoles
#9
René Jørgensen, Siri Rytcher Andersen, Karen Marie Thyssen Astvad, Maiken Cavling Arendrup
Isavuconazole (ISZ) is a newly available broad-spectrum triazole agent recently approved for the treatment of both invasive aspergillosis and mucormycosis. The aim of this study was to develop a simple and reliable method for therapeutic drug monitoring (TDM) of ISZ in human plasma samples. The method involves using a kit from ChromSystems intended for TDM of itraconazole (ITZ), posaconazole (PSZ), and voriconazole (VRZ) in serum/plasma for sample preparation and high-performance liquid chromatography, using fluorescence detection with emission and excitation wavelengths set to 261 and 366 nm, respectively...
May 2017: MSphere
https://www.readbyqxmd.com/read/28409094/successful-treatment-of-azole-resistant-invasive-aspergillosis-in-a-bottlenose-dolphin-with-high-dose-posaconazole
#10
Paulien E Bunskoek, Seyedmojtaba Seyedmousavi, Steven J M Gans, Peter B J van Vierzen, Willem J G Melchers, Cornelis E van Elk, Johan W Mouton, Paul E Verweij
Invasive aspergillosis due to azole-resistant Aspergillus fumigatus is difficult to manage. We describe a case of azole-resistant invasive aspergillosis in a female bottlenose dolphin, who failed to respond to voriconazole and posaconazole therapy. As intravenous therapy was precluded, high dose posaconazole was initiated aimed at achieving trough levels exceeding 3 mg/l. Posaconazole serum levels of 3-9.5 mg/l were achieved without significant side-effects. Follow-up bronchoscopy and computed tomography showed complete resolution of the lesions...
June 2017: Medical Mycology Case Reports
https://www.readbyqxmd.com/read/28407752/detection-of-high-serum-levels-of-%C3%AE-d-glucan-in-disseminated-nocardial-infection-a-case-report
#11
Toyomitsu Sawai, Takumi Nakao, Shota Yamaguchi, Sumako Yoshioka, Nobuko Matsuo, Naofumi Suyama, Katsunori Yanagihara, Hiroshi Mukae
BACKGROUND: β-D-glucan (BDG) is a helpful diagnostic marker for many invasive fungal infections, but not for nocardiosis. Here, we reported the first case of nocardial infection with high serum level of BDG. CASE PRESENTATION: A 73-year-old man was hospitalized because of fever, headache, and appetite loss after 10 months of steroid and immunosuppressive therapy for cryptogenic organizing pneumonia. With a diagnosis of bacterial pneumonia, treatment with ampicillin/sulbactam was initiated...
April 13, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28407118/voriconazole-dosing-in-children-younger-than-3-years-undergoing-cancer-chemotherapy-or-hematopoietic-stem-cell-transplantation
#12
Shirley Qiong Yan, Brian Seyboth, Rachel Kobos, Anne Eaton, Susan K Seo, Nina Cohen
There are limited pediatric population pharmacokinetic data for voriconazole dosing, particularly in younger children. In a cohort of 34 patients younger than 3 years receiving voriconazole, the majority (n = 23, 68%) had a low initial serum concentration <1 mg/L. Among 23 children <2 years old, 19 (83%) had an initial trough <1 mg/L. There was large intra- and interindividual variability in trough levels. Dosing also varied from 3.3 to 19.6 mg/kg per dose. Only 2 of 34 patients had a documented adverse drug reaction attributable to voriconazole...
April 12, 2017: Journal of the Pediatric Infectious Diseases Society
https://www.readbyqxmd.com/read/28378982/early-diagnosis-and-treatment-of-invasive-aspergillosis-as-a-main-determinant-of-outcome-review-of-literature-according-to-the-presented-case-report
#13
Michał Borys, Paweł Piwowarczyk, Justyna Sysiak, Mirosław Czuczwar, Andrzej Prystupa
Although. Aspergillus spp infection is not the major cause of morbidity in Intensive Care Units (ICUs), mortality among patients treated for it is tremendous. Moreover, invasive aspergillosis (IA) is an independent risk factor of hospital costs and length of stay. The prevalence of this disease is inversely correlated with the immunocompetence of individuals; for instance, the incidence of IA among patients with leukemia is estimated as high as 12.7%. Although there is a significant improvement in the antifungal armamentarium, the appropriate treatment is still being given too late, mostly because of late diagnosis...
March 21, 2017: Annals of Agricultural and Environmental Medicine: AAEM
https://www.readbyqxmd.com/read/28355467/new-pharmacological-opportunities-for-the-treatment-of-invasive-mould-diseases
#14
Marie-Pierre Ledoux, Elise Toussaint, Julie Denis, Raoul Herbrecht
Recently, several randomized studies have been published that will shape treatment decisions in the prevention and management of invasive mould infections. Liposomal amphotericin B is an option for empirical or targeted treatment of invasive aspergillosis or mucormycosis, but for prophylaxis therapy, the triazole class now predominates. The triazole voriconazole is currently regarded as a drug of choice for the treatment of proven or probable invasive aspergillosis, and has shown significantly higher response rates than amphotericin B deoxycholate in this setting, with fewer severe drug-related adverse events...
March 1, 2017: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/28355466/invasive-mould-infections-in-the-icu-setting-complexities-and-solutions
#15
REVIEW
Matteo Bassetti, Emilio Bouza
Infections caused by filamentous fungi represent a major burden in the ICU. Invasive aspergillosis is emerging in non-neutropenic individuals with predisposing conditions, e.g. corticosteroid treatment, chronic obstructive pulmonary disease, liver cirrhosis, solid organ cancer, HIV infection and transplantation. Diagnosis is challenging because the signs and symptoms are non-specific, and initiation of additional diagnostic examinations is often delayed because clinical suspicion is low. Isolation of an Aspergillus species from the respiratory tract in critically ill patients, and tests such as serum galactomannan, bronchoalveolar lavage 1-3-β-d-glucan and specific PCR should be interpreted with caution...
March 1, 2017: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/28355463/therapeutic-drug-monitoring-for-invasive-mould-infections-and-disease-pharmacokinetic-and-pharmacodynamic-considerations
#16
REVIEW
Katharine E Stott, William W Hope
Therapeutic drug monitoring (TDM) may be required to achieve optimal clinical outcomes in the setting of significant pharmacokinetic variability, a situation that applies to a number of anti-mould therapies. The majority of patients receiving itraconazole should routinely be managed with TDM. Voriconazole exhibits highly variable inter-individual pharmacokinetics, and a trough concentration of 1.0-5.5 mg/L is widely accepted although it is derived from relatively low-quality evidence. The case for TDM of posaconazole is currently in a state of flux following the introduction of a newer tablet formulation with improved oral bioavailability, but it may be indicated when used for either prophylaxis or treatment of established disease...
March 1, 2017: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/28306482/serum-c-reactive-protein-levels-affect-the-plasma-voriconazole-trough-levels-in-allogeneic-hematopoietic-cell-transplant-recipients
#17
Takeo Yasu, Takaaki Konuma, Seiko Kato, Yosuke Kurokawa, Satoshi Takahashi, Arinobu Tojo
No abstract text is available yet for this article.
March 17, 2017: Leukemia & Lymphoma
https://www.readbyqxmd.com/read/28012684/bioavailability-of-voriconazole-in-hospitalised-patients
#18
Anette Veringa, Sanne Geling, Lambert F R Span, Karin M Vermeulen, Jan G Zijlstra, Tjip S van der Werf, Jos G W Kosterink, Jan-Willem C Alffenaar
An important element in antimicrobial stewardship programmes is early switch from intravenous (i.v.) to oral antimicrobial treatment, especially for highly bioavailable drugs. The antifungal agent voriconazole is available both in i.v. and oral formulations and bioavailability is estimated to be >90% in healthy volunteers, making this drug a suitable candidate for such a transition. Recently, two studies have shown that the bioavailability of voriconazole is substantially lower in patients. However, for both studies various factors that could influence the voriconazole serum concentration, such as inflammation, concomitant intake of food with oral voriconazole, and gastrointestinal complications, were not included in the evaluation...
February 2017: International Journal of Antimicrobial Agents
https://www.readbyqxmd.com/read/27981572/clinical-pharmacogenetics-implementation-consortium-cpic-guidelines-for-cyp2c19-and-voriconazole-therapy
#19
B Moriyama, A Owusu Obeng, J Barbarino, S R Penzak, S A Henning, S A Scott, Jag Agúndez, J R Wingard, H L McLeod, T E Klein, S J Cross, K E Caudle, T J Walsh
Voriconazole, a triazole antifungal agent, demonstrates wide interpatient variability in serum concentrations, due in part to variant CYP2C19 alleles. Individuals who are CYP2C19 ultrarapid metabolizers have decreased trough voriconazole concentrations, delaying achievement of target blood concentrations; whereas poor metabolizers have increased trough concentrations and are at increased risk of adverse drug events. We summarize evidence from the literature supporting this association and provide therapeutic recommendations for the use of voriconazole for treatment based on CYP2C19 genotype (updates at https://cpicpgx...
December 16, 2016: Clinical Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/27939578/disseminated-aspergillosis-in-an-immunocompetent-patient-with-detectable-bis-methylthio-gliotoxin-and-negative-galactomannan
#20
Matxalen Vidal-García, Pilar Sáncehez-Chueca, María Pilar Domingo, Carlos Ballester, Lourdes Roc, Isabel Ferrer, María José Revillo, Julián Pardo, Eva María Gálvez, Antonio Rezusta
BACKGROUND: Disseminated invasive aspergillosis is an exceptional finding in immunocompetent hosts. As in immunocompromised patients, it has high mortality rates. Early diagnostic methods are required in order to properly manage the patient. Bis(methylthio)gliotoxin (bmGT) is a novel biomarker, useful in onco-hematological patients. CASE REPORT: A 70-year-old male, with non-insulin dependent type II diabetes mellitus and a past surgery history of aortic valve replacement with coronary by-pass five years ago, was seen in the emergency department with blurred vision...
December 8, 2016: Revista Iberoamericana de Micología
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